Healthcare Provider Details

I. General information

NPI: 1669376661
Provider Name (Legal Business Name): PAUL A DATTI LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CHERRY ST
SCRANTON PA
18505-1505
US

IV. Provider business mailing address

509 COLFAX AVE
SCRANTON PA
18510-2364
US

V. Phone/Fax

Practice location:
  • Phone: 570-348-6100
  • Fax:
Mailing address:
  • Phone: 570-677-1238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC018704
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: